Monitoring of hepatitis b virus (HBV) DNA and risk of HBV reactivation in B-cell lymphoma: A prospective observational study

Shigeru Kusumoto; Yasuhito Tanaka; Ritsuro Suzuki; Takashi Watanabe; Masanobu Nakata; Hirotaka Takasaki; Noriyasu Fukushima; Takuya Fukushima; Yukiyoshi Moriuchi; Kuniaki Itoh; Kisato Nosaka; Ilseung Choi; Masashi Sawa; Rumiko Okamoto; Hideki Tsujimura; Toshiki Uchida; Sachiko Suzuki; Masataka Okamoto; Tsutomu Takahashi; Isamu Sugiura; Yasushi Onishi; Mika Kohri; Shinichiro Yoshida; Rika Sakai; Minoru Kojima; Hiroyuki Takahashi; Akihiro Tomita; Dai Maruyama; Yoshiko Atsuta; Eiji Tanaka; Takayo Suzuki; Tomohiro Kinoshita; Michinori Ogura; Masashi Mizokami; Ryuzo Ueda

doi:10.1093/cid/civ344

Monitoring of hepatitis b virus (HBV) DNA and risk of HBV reactivation in B-cell lymphoma: A prospective observational study

Shigeru Kusumoto, Yasuhito Tanaka, Ritsuro Suzuki, Takashi Watanabe, Masanobu Nakata, Hirotaka Takasaki, Noriyasu Fukushima, Takuya Fukushima, Yukiyoshi Moriuchi, Kuniaki Itoh, Kisato Nosaka, Ilseung Choi, Masashi Sawa, Rumiko Okamoto, Hideki Tsujimura, Toshiki Uchida, Sachiko Suzuki, Masataka Okamoto, Tsutomu Takahashi, Isamu SugiuraYasushi Onishi, Mika Kohri, Shinichiro Yoshida, Rika Sakai, Minoru Kojima, Hiroyuki Takahashi, Akihiro Tomita, Dai Maruyama, Yoshiko Atsuta, Eiji Tanaka, Takayo Suzuki, Tomohiro Kinoshita, Michinori Ogura, Masashi Mizokami, Ryuzo Ueda

Internal Medicine

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137 Citations (Scopus)

Abstract

Background. There is no standard management of reactivation of hepatitis B virus (HBV) infection in HBVresolved patients without hepatitis B surface antigen (HBsAg), but with antibodies against hepatitis B core antigen and/or antibodies against HBsAg (anti-HBs). Methods. We conducted a prospective observational study to evaluate the occurrence of HBV reactivation by serial monthly monitoring of HBV DNA and to establish preemptive therapy guided by this monitoring in B-cell non-Hodgkin lymphoma (B-NHL) treated with rituximab plus corticosteroid-containing chemotherapy (R-steroidchemo). The primary endpoint was the incidence of HBV reactivation defined as quantifiable HBV DNA levels of ?11 IU/mL. Results. With a median HBV DNA follow-up of 562 days, HBV reactivation was observed in 21 of the 269 analyzed patients. The incidence of HBV reactivation at 1.5 years was 8.3% (95% confidence interval, 5.5-12.4). No hepatitis due to HBV reactivation was observed in patients who received antiviral treatment when HBV DNA levels were between 11 and 432 IU/mL. An anti-HBs titer of <10 mIU/mL and detectable HBV DNA remaining below the level of quantification at baseline were independent risk factors for HBV reactivation (hazard ratio, 20.6 and 56.2, respectively; P < .001). Even in 6 patients with a rapid increase of HBV due to mutations, the monthly HBV DNA monitoring was effective at preventing HBV-related hepatitis. Conclusions. Monthly monitoring of HBV DNA is useful for preventing HBV reactivation-related hepatitis among B-NHL patients with resolved HBV infection following R-steroid-chemo (UMIN000001299).

Original language	English
Pages (from-to)	719-729
Number of pages	11
Journal	Clinical Infectious Diseases
Volume	61
Issue number	5
DOIs	https://doi.org/10.1093/cid/civ344
Publication status	Published - 01-09-2015

All Science Journal Classification (ASJC) codes

Microbiology (medical)
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/cid/civ344

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Kusumoto, S., Tanaka, Y., Suzuki, R., Watanabe, T., Nakata, M., Takasaki, H., Fukushima, N., Fukushima, T., Moriuchi, Y., Itoh, K., Nosaka, K., Choi, I., Sawa, M., Okamoto, R., Tsujimura, H., Uchida, T., Suzuki, S., Okamoto, M., Takahashi, T., ... Ueda, R. (2015). Monitoring of hepatitis b virus (HBV) DNA and risk of HBV reactivation in B-cell lymphoma: A prospective observational study. Clinical Infectious Diseases, 61(5), 719-729. https://doi.org/10.1093/cid/civ344

@article{a2d524384cf54c8ab5b24ea3ad3da17a,

title = "Monitoring of hepatitis b virus (HBV) DNA and risk of HBV reactivation in B-cell lymphoma: A prospective observational study",

abstract = "Background. There is no standard management of reactivation of hepatitis B virus (HBV) infection in HBVresolved patients without hepatitis B surface antigen (HBsAg), but with antibodies against hepatitis B core antigen and/or antibodies against HBsAg (anti-HBs). Methods. We conducted a prospective observational study to evaluate the occurrence of HBV reactivation by serial monthly monitoring of HBV DNA and to establish preemptive therapy guided by this monitoring in B-cell non-Hodgkin lymphoma (B-NHL) treated with rituximab plus corticosteroid-containing chemotherapy (R-steroidchemo). The primary endpoint was the incidence of HBV reactivation defined as quantifiable HBV DNA levels of ?11 IU/mL. Results. With a median HBV DNA follow-up of 562 days, HBV reactivation was observed in 21 of the 269 analyzed patients. The incidence of HBV reactivation at 1.5 years was 8.3% (95% confidence interval, 5.5-12.4). No hepatitis due to HBV reactivation was observed in patients who received antiviral treatment when HBV DNA levels were between 11 and 432 IU/mL. An anti-HBs titer of <10 mIU/mL and detectable HBV DNA remaining below the level of quantification at baseline were independent risk factors for HBV reactivation (hazard ratio, 20.6 and 56.2, respectively; P < .001). Even in 6 patients with a rapid increase of HBV due to mutations, the monthly HBV DNA monitoring was effective at preventing HBV-related hepatitis. Conclusions. Monthly monitoring of HBV DNA is useful for preventing HBV reactivation-related hepatitis among B-NHL patients with resolved HBV infection following R-steroid-chemo (UMIN000001299).",

keywords = "HBV DNA monitoring, HBV reactivation, Preemptive antiviral therapy, Resolved HBV infection, Rituximab",

author = "Shigeru Kusumoto and Yasuhito Tanaka and Ritsuro Suzuki and Takashi Watanabe and Masanobu Nakata and Hirotaka Takasaki and Noriyasu Fukushima and Takuya Fukushima and Yukiyoshi Moriuchi and Kuniaki Itoh and Kisato Nosaka and Ilseung Choi and Masashi Sawa and Rumiko Okamoto and Hideki Tsujimura and Toshiki Uchida and Sachiko Suzuki and Masataka Okamoto and Tsutomu Takahashi and Isamu Sugiura and Yasushi Onishi and Mika Kohri and Shinichiro Yoshida and Rika Sakai and Minoru Kojima and Hiroyuki Takahashi and Akihiro Tomita and Dai Maruyama and Yoshiko Atsuta and Eiji Tanaka and Takayo Suzuki and Tomohiro Kinoshita and Michinori Ogura and Masashi Mizokami and Ryuzo Ueda",

year = "2015",

month = sep,

day = "1",

doi = "10.1093/cid/civ344",

language = "English",

volume = "61",

pages = "719--729",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

number = "5",

}

Kusumoto, S, Tanaka, Y, Suzuki, R, Watanabe, T, Nakata, M, Takasaki, H, Fukushima, N, Fukushima, T, Moriuchi, Y, Itoh, K, Nosaka, K, Choi, I, Sawa, M, Okamoto, R, Tsujimura, H, Uchida, T, Suzuki, S, Okamoto, M, Takahashi, T, Sugiura, I, Onishi, Y, Kohri, M, Yoshida, S, Sakai, R, Kojima, M, Takahashi, H, Tomita, A, Maruyama, D, Atsuta, Y, Tanaka, E, Suzuki, T, Kinoshita, T, Ogura, M, Mizokami, M & Ueda, R 2015, 'Monitoring of hepatitis b virus (HBV) DNA and risk of HBV reactivation in B-cell lymphoma: A prospective observational study', Clinical Infectious Diseases, vol. 61, no. 5, pp. 719-729. https://doi.org/10.1093/cid/civ344

TY - JOUR

T1 - Monitoring of hepatitis b virus (HBV) DNA and risk of HBV reactivation in B-cell lymphoma

T2 - A prospective observational study

AU - Kusumoto, Shigeru

AU - Tanaka, Yasuhito

AU - Suzuki, Ritsuro

AU - Watanabe, Takashi

AU - Nakata, Masanobu

AU - Takasaki, Hirotaka

AU - Fukushima, Noriyasu

AU - Fukushima, Takuya

AU - Moriuchi, Yukiyoshi

AU - Itoh, Kuniaki

AU - Nosaka, Kisato

AU - Choi, Ilseung

AU - Sawa, Masashi

AU - Okamoto, Rumiko

AU - Tsujimura, Hideki

AU - Uchida, Toshiki

AU - Suzuki, Sachiko

AU - Okamoto, Masataka

AU - Takahashi, Tsutomu

AU - Sugiura, Isamu

AU - Onishi, Yasushi

AU - Kohri, Mika

AU - Yoshida, Shinichiro

AU - Sakai, Rika

AU - Kojima, Minoru

AU - Takahashi, Hiroyuki

AU - Tomita, Akihiro

AU - Maruyama, Dai

AU - Atsuta, Yoshiko

AU - Tanaka, Eiji

AU - Suzuki, Takayo

AU - Kinoshita, Tomohiro

AU - Ogura, Michinori

AU - Mizokami, Masashi

AU - Ueda, Ryuzo

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Background. There is no standard management of reactivation of hepatitis B virus (HBV) infection in HBVresolved patients without hepatitis B surface antigen (HBsAg), but with antibodies against hepatitis B core antigen and/or antibodies against HBsAg (anti-HBs). Methods. We conducted a prospective observational study to evaluate the occurrence of HBV reactivation by serial monthly monitoring of HBV DNA and to establish preemptive therapy guided by this monitoring in B-cell non-Hodgkin lymphoma (B-NHL) treated with rituximab plus corticosteroid-containing chemotherapy (R-steroidchemo). The primary endpoint was the incidence of HBV reactivation defined as quantifiable HBV DNA levels of ?11 IU/mL. Results. With a median HBV DNA follow-up of 562 days, HBV reactivation was observed in 21 of the 269 analyzed patients. The incidence of HBV reactivation at 1.5 years was 8.3% (95% confidence interval, 5.5-12.4). No hepatitis due to HBV reactivation was observed in patients who received antiviral treatment when HBV DNA levels were between 11 and 432 IU/mL. An anti-HBs titer of <10 mIU/mL and detectable HBV DNA remaining below the level of quantification at baseline were independent risk factors for HBV reactivation (hazard ratio, 20.6 and 56.2, respectively; P < .001). Even in 6 patients with a rapid increase of HBV due to mutations, the monthly HBV DNA monitoring was effective at preventing HBV-related hepatitis. Conclusions. Monthly monitoring of HBV DNA is useful for preventing HBV reactivation-related hepatitis among B-NHL patients with resolved HBV infection following R-steroid-chemo (UMIN000001299).

AB - Background. There is no standard management of reactivation of hepatitis B virus (HBV) infection in HBVresolved patients without hepatitis B surface antigen (HBsAg), but with antibodies against hepatitis B core antigen and/or antibodies against HBsAg (anti-HBs). Methods. We conducted a prospective observational study to evaluate the occurrence of HBV reactivation by serial monthly monitoring of HBV DNA and to establish preemptive therapy guided by this monitoring in B-cell non-Hodgkin lymphoma (B-NHL) treated with rituximab plus corticosteroid-containing chemotherapy (R-steroidchemo). The primary endpoint was the incidence of HBV reactivation defined as quantifiable HBV DNA levels of ?11 IU/mL. Results. With a median HBV DNA follow-up of 562 days, HBV reactivation was observed in 21 of the 269 analyzed patients. The incidence of HBV reactivation at 1.5 years was 8.3% (95% confidence interval, 5.5-12.4). No hepatitis due to HBV reactivation was observed in patients who received antiviral treatment when HBV DNA levels were between 11 and 432 IU/mL. An anti-HBs titer of <10 mIU/mL and detectable HBV DNA remaining below the level of quantification at baseline were independent risk factors for HBV reactivation (hazard ratio, 20.6 and 56.2, respectively; P < .001). Even in 6 patients with a rapid increase of HBV due to mutations, the monthly HBV DNA monitoring was effective at preventing HBV-related hepatitis. Conclusions. Monthly monitoring of HBV DNA is useful for preventing HBV reactivation-related hepatitis among B-NHL patients with resolved HBV infection following R-steroid-chemo (UMIN000001299).

KW - HBV DNA monitoring

KW - HBV reactivation

KW - Preemptive antiviral therapy

KW - Resolved HBV infection

KW - Rituximab

UR - http://www.scopus.com/inward/record.url?scp=84942038524&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84942038524&partnerID=8YFLogxK

U2 - 10.1093/cid/civ344

DO - 10.1093/cid/civ344

M3 - Article

C2 - 25935551

AN - SCOPUS:84942038524

SN - 1058-4838

VL - 61

SP - 719

EP - 729

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 5

ER -

Monitoring of hepatitis b virus (HBV) DNA and risk of HBV reactivation in B-cell lymphoma: A prospective observational study

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